Although most German GPs consider sexual health an important topic and feel responsible for addressing it, nearly half report discussing sexual issues less often than medically indicated, with barriers including lack of time, language barriers, and presence of relatives.
Most German GPs consider sexual health an important health topic and feel responsible for addressing it with patients.
Nearly half of German GPs report addressing sexual health issues less often than medically indicated.
The main barriers to discussing sexual health in primary care include lack of time, language barriers, and the presence of relatives.
Patients' own initiative and a good and/or long-term doctor-patient relationship were identified as facilitating factors for sexual health conversations.
Several GP characteristics were associated with differences in how often sexual health topics are discussed and how barriers and facilitators are perceived.
The authors recommend that structured communication training and improved sexual health competence should be more strongly represented in medical school curricula and GP training courses.
This research surveyed 249 general practitioners (family doctors) in Germany between late 2021 and mid-2022 to understand how they approach sexual health conversations with patients. The study found that most GPs recognize sexual health as an important medical issue and believe it is their responsibility to address it — yet nearly half admit they bring it up less often than they medically should. This gap between what doctors believe they should do and what they actually do in practice is a central finding of the study. The research identified several reasons why these conversations don't happen as often as they should. Time pressure during appointments, difficulty communicating with patients who speak a different language, and the presence of family members or companions during consultations all made it harder for GPs to raise sexual health topics. On the other hand, when patients themselves brought up the subject, or when there was an established, trusting relationship between doctor and patient, conversations were more likely to occur. The study also found that the doctor's own characteristics — including their age, gender, years in practice, sexual orientation, and whether they had positive past experiences discussing sexual health — influenced how they handled these conversations. This research suggests that there is a meaningful gap in sexual healthcare being delivered in German primary care settings, even though GPs generally value the topic. The findings point to a practical solution: better training in sexual health communication during medical school and continuing professional education for GPs could help doctors feel more confident and equipped to raise these issues with patients, potentially improving the overall quality of care patients receive for sexual health concerns.
Solbach J, Kersting C, Mortsiefer A. (2025). Talking about sexual health in primary care: Results of a cross-sectional study among general practitioners in Germany.. Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen. https://doi.org/10.1016/j.zefq.2025.06.002